Organization
GUARDIAN SERVANT CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDGAR GONATICE MS (MANAGING DIRECTOR)
(808) 640-5878
Entity
Organization
Contact information
Practice address
620 BERKLEY DR, GRAPEVINE, TX 76051-5190
(808) 640-5878
Mailing address
620 BERKLEY DR, GRAPEVINE, TX 76051-5190
(808) 640-5878
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
08/12/2014
Last updated
08/12/2014
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